How to obtain DCFSA benefits
UnitedHealthcare processes DCFSA claims. You must submit a claim form and appropriate documentation in order to receive payment from the DCFSA. Examples of acceptable documentation include:
- A receipt or itemized statement from a licensed day care center showing dates of service and the amount charged
- A canceled check showing the dates of service and the name of your day care provider (This is adequate documentation only if a relative provides services.)
Photocopies of canceled checks are not considered acceptable documentation.
Completed claim forms should be sent to:
Health Care Account Service Center
P.O. Box 981506
El Paso, Texas 79998-1506
P.O. Box 981506
El Paso, Texas 79998-1506
If you prefer, you can submit your claims via fax at 915 231 1709.
When you enroll in the DCFSA, you may choose to have your claim reimbursements deposited directly to your bank account. If you elect the direct deposit option, you will receive a notice each time a claim is paid. The notice will indicate the amount of the reimbursement and the date it was deposited to your account.
DCFSA claims are processed every week. If your claim is in order, it will be processed promptly, and a reimbursement check (or direct deposit verification notice) will be sent to your home. However, you should be aware that claim processing might be delayed in the following circumstances:
- If your claim form is incomplete or if you have not provided necessary documentation, your claim form will be returned to you.
- If your claim exceeds your current DCFSA balance, claim payment will be based on the account balance amount. The remaining claim amount will be held until the next claim-processing period.
- If your claim includes amounts paid in advance, payment is based upon services actually provided as of the claims processing date. Amounts paid for future services will be held until charges are incurred.
You can be reimbursed only for expenses incurred during the same year you put money in the DCFSA. For example, only day care expenses incurred during 2024 and filed with UnitedHealthcare by March 31, 2025 can be reimbursed from your 2024 DCFSA, with the exception of the grace period as noted below.
DCFSA plans include a grace period. If you have unused contributions in your account at the end of the current plan year you can continue to incur expenses during the first 2.5 months immediately following the end of the plan year and receive reimbursement for these expenses until such unused funds are depleted. All requests for reimbursement will be accepted and processed through March 31 of the following year. For example, if you have $1000 in unused contributions remaining at the end of the current plan year, you may use eligible expenses incurred through March 15 to deplete those funds, and submit the claims by March 31. Any expenses incurred after March 15 would count toward the current plan year account, if you have one. According to Internal Revenue Service regulations, after March 31 funds remaining in your account for the previous plan year will be forfeited.
DCFSA claim forms are available from your Benefits representative, by calling UnitedHealthcare toll free at 800 387 7508 or at www.myuhc.com, the UnitedHealthcare website. You can elect to have DCFSA reimbursements deposited to your checking account by visiting the UnitedHealthcare website at www.myuhc.com.
If UnitedHealthcare denies your claim for a benefit in whole or in part, you will receive a written notice that will provide:
- The specific reason or reasons for the denial
- Reference to specific plan provisions on which the determination was based
- A description of any additional material or information necessary to complete the claim and an explanation of why such material or information is necessary
- A description of the steps you must follow (including applicable time limits) if you want to appeal the adverse benefit determination of your claim, including, in the case of an adverse benefit determination of a claim for reimbursement under the DCFSA:
- Your right to submit written comments and have them considered
- Your right to receive (upon request and free of charge) reasonable access to, and copies of, all documents, records and other information relevant to your claim
- If the claim administrator relied on an internal rule, guideline, protocol or other similar criterion in denying your claim, either:
If you have a question or concern about a benefit determination, you may informally contact a UnitedHealthcare customer service representative before requesting a formal appeal. The customer service telephone number is 800 387 7508. If the customer service representative cannot resolve the issue to your satisfaction, you may request a formal appeal.
If you wish to request a formal appeal of a denied claim, you should contact customer service to obtain the UnitedHealthcare address where the appeal should be sent. Your appeal should be submitted in writing to that address and should include your name, a description of the claim determination that you are appealing, the reason you believe the claim should be paid and any written information to support your appeal.
Your first level appeal request must be made in writing to the claim administrator within 180 days after you receive the written notice that your claim has been denied in whole or in part. If you do not file your appeal within this time period, you will lose the right to appeal the denial.
Your written appeal should set out the reasons you believe that the claim should not have been denied and should also include any additional supporting information, documents or comments that you consider appropriate. At your request, you will be provided, free of charge, with reasonable access to, and copies of, all documents, records and other information relevant to the claim.
UnitedHealthcare will review the first level appeal request and notify you of the decision in writing within 30 days from receipt of a request for appeal of a denied claim. If you are not satisfied with the first level appeal decision, you have the right to request a second level appeal from UnitedHealthcare. Your second level appeal request must be submitted in writing to UnitedHealthcare within 60 days from receipt of the first level appeal decision. The second level appeal will be conducted and you will be notified by UnitedHealthcare of the decision in writing within 30 days from receipt of a request for a second level appeal.
UnitedHealthcare has the exclusive right to interpret and administer Stryker's day care (child and adult) flexible spending account plan, and these decisions are conclusive and binding.
The review will take into account all comments, documents, records and other information relating to the claim that you submit without regard to whether such information was submitted or considered in the initial benefit determination. The review will not give deference to the initial denial. In addition, the individual who decides your appeal will not be the same individual who decided your initial claim denial and will not be that individual's subordinate.
You will be notified in writing of the decision on appeal. If the decision upholds the initial adverse benefit determination of your claim, the notification will provide:
- The specific reason or reasons for the denial
- Reference to specific plan provisions on which the determination was based
- A description of your right to receive (upon request and free of charge) reasonable access to, and copies of, all documents, records and other information relevant to your claim
- If an internal rule, guideline, protocol or other similar criterion was relied on in denying your claim, either:
If your claim is denied based on a determination that an individual is not eligible for benefits, you have 180 calendar days after receiving the adverse benefit determination notice in which to appeal the determination to the plan administrator. Your appeal must be in writing. If you do not file an appeal within this 180-day period, you will lose the right to appeal the determination.
Your written appeal should state that it is an appeal, set out the reasons you believe that the claim should not have been denied and should also include any additional supporting information, documents or comments that you consider appropriate and describe the specific details of what happened to cause the issue resulting in ineligibility. At your request, you will be provided, free of charge, with reasonable access to, and copies of, all documents, records, and other information relevant to the claim.
Submit your appeal to the following address:
Stryker Benefits Committee
Attn: Health Plan Administrator
Stryker
1901 Romence Road Parkway
Portage, MI 49002
Attn: Health Plan Administrator
Stryker
1901 Romence Road Parkway
Portage, MI 49002
The plan administrator will review and decide your appeal within a reasonable period of time but no longer than 60 days after it is submitted. The review will take into account all comments, documents, records and other information relating to the claim that you submit without regard to whether such information was submitted or considered in the initial benefit determination. The review will not give deference to the initial denial. In addition, the individual who decides your appeal will not be the same individual who denied your initial claim and will not be that individual's subordinate. The decision of the plan administrator is final and binding on all individuals claiming benefits under the plan.